U.S. BUREAU OF LABOR STATISTICS
GLOSSARY
Access to a benefit plan. Employees are
considered to have access to a benefit plan if
it is available for their use. For example, if
an employee is permitted to participate in a
medical care plan offered by the employer,
he or she is placed in a category with those
having access to medical care, regardless of
whether he or she chooses to participate.
Participation in a benefit plan. Employees
in contributory plans are considered to be
participants in an insurance or retirement
plan if they have paid required contributions
and fulfilled all applicable service
requirements. Employees in noncontributory
plans are counted as participating regardless
of whether they have fulfilled the service
requirements.
Take-up rate of a benefit plan. The take-up
rate is the percentage of workers with access
to a plan who participate in the plan. Take-up
rates are computed by dividing the number
of workers participating in a plan by the
number of workers with access to the plan,
multiplying by 100, and rounding to the
nearest 1 percent.
Health savings accounts (HSAs). These are
accounts that allow employees to pay for
future medical expenses with tax-exempt
contributions. HSAs must be used in
conjunction with employer-provided,
high-deductible health plans with an annual
maximum limit on out-of-pocket and
deductible expenses. Other features include
the rollover of unused contributions, the
portability of accounts, and tax-free interest.
Health reimbursement accounts (or flexible
spending accounts). These are accounts
that provide employees the opportunity to
allocate pretax amounts for out-of-pocket
qualified expenses, including deductibles,
copayments, and other health care costs not
covered by their health insurance.
Wellness program. A wellness program is a
structured plan, independent from health
insurance, that offers employees two or
more of the following benefits: smoking
cessation programs, exercise/physical
fitness programs, weight control programs,
nutrition education, hypertension tests,
periodic physical examinations, stress
management programs, back care courses,
or life style assessment tests.
Employer assistance program. This is a
structured plan, independent from health
insurance, that provides employee referral
services, or referral and counseling services,
concerning alcoholism, drug abuse, marital
difficulties, financial problems, emotional
problems, and legal problems.
TABLE 3
PERSPECTIVES
ROGRAM
Medical plans: average monthly employer premium and
share of premium paid by employer, by single coverage
and family coverage, for all workers, by private industry
and State and local government, March 2008
Private industry
State and local
government
Average employer premium for all
workers with coverage
$309.03
$399.86
Share of premium paid by employer
81%
90%
Average employer premium for all
workers with coverage
$708.83
$794.72
Share of premium paid by employer
71%
73%
Selected benefit
OCTOBER 2008
Family coverage
►
of the differences between them
NATIONAL
COMPENSATION
SURVEY
Benefits Series
State and local government
are due to variations in work
employers paid 90 percent of the
activities and occupational
premium for single coverage and
structures. For further information
73 percent for family coverage.
When comparing benefit costs
in private industry with those
in State and local government,
it is important to note that some
see: “Compensation Cost Trends
www.bls.gov/ ebs
in Private Industry and State
HEALTH
HEALTH
and Local Governments” at
www.bls.gov/opub/cwc/archive/
fall1999art2.pdf. ●
PAID LEAVE
RETIREMENT
For additional assistance on
benefits, contact one of our
information offices:
REGIONAL:
ATLANTA
(404) 893-4222
NATIONAL: WASHINGTON, DC
BOSTON
(617) 565-2327
(202) 691-6199 TDD: (800) 877-8339
[email protected] www.bls.gov/ebs
CHICAGO
(312) 353-1880
DALLAS
(214) 767-6970
KANSAS CITY
(816) 285-7000
NEW YORK
(646) 264-3600
PHILADELPHIA
(215) 597-3282
SAN FRANCISCO
(415) 625-2270
O N H E A LT H B E N E F I T S
Recent data on
employers’ costs and
employees’ access
Single coverage
from page 3
ISSUE 1
Welcome to the
inaugural issue of
Program Perspectives,
a new publication from
the U.S. Bureau of Labor
Statistics in which BLS
programs showcase
their latest data.
H
ealth care continues to be
a topic of great concern
to many Americans.
Employers worry about the rising
cost of the health insurance plans
they offer their workers. Consumers
worry that increasing out-of-pocket
expenses make their budgets ever
more vulnerable. This issue of
Program Perspectives highlights
how data from the National
care premiums for employees
with family coverage than for
employees with single coverage.
Compensation Survey provide
useful information and context for
understanding the issues. Key
findings include the following: the
costs of employer-provided health
benefits have increased dramatically
since 1981—by approximately eightfold; State and local government
workers have substantially higher
access to health plans than private
industry workers; and employers
pay a lower percentage of health
Employer costs for health benefits
for private industry workers
increased 4.2 percent for the
12-month period ending June 2008.
These estimates do not reflect
changes in costs to employees or
adjust for changes in the plans
available to employees; costs to
employees have increased because
of higher premiums, deductibles,
and copayments.
The next two issues of Program
Perspectives will feature paid leave
benefits and retirement benefits,
respectively.
Trends in employer
costs for health
benefits
continued inside
►
TABLE 1
CHART 1
Employment Cost Index, private industry, 12-month percent change,
health benefits and total benefits,* 1982–2008
Health benefits: access, participation, and take-up rates
for all workers, by private industry and State and local
government, March 2008 (in percent)
Access
Participation
Take-up rate
Medical care
71
53
75
Dental care
47
37
79
18
Vision care
28
22
78
15
Outpatient prescription
drug coverage
68
51
75
Medical care
87
73
83
Dental care
55
47
85
Vision care
38
31
81
Outpatient prescription
drug coverage
86
72
83
Percent
24
Private industry
21
Health benefits
12
State and local government
9
6
Total benefits
3
0
-3
82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09
Year
*Total benefits includes: paid leave, supplemental pay, insurance, retirement and savings, and legally required benefits.
from cover page
►
Over the last 25 years, the
growth in health benefit costs for
employers has moved in fits and
starts, as can be seen in Chart 1.
In March 1983 health benefit costs
recorded a 23.5 percent increase
from a year earlier. After that,
growth in costs decelerated for 3
years, followed by 2½ years of
acceleration. In December 1988,
another period of deceleration
began, a period that was slower
and longer than the first—lasting
over 7 years until employer costs
for health benefits declined by
2 PROGRAM PERSPECTIVES • OCTOBER 2008
0.3 percent in March 1996.
Costs remained relatively flat for
about the next year and then grew
more and more rapidly for 5 years.
Then, in June 2002, growth in
health benefit costs began to
decelerate; this slowing has
continued into the current period.
(For further information on the
Employment Cost Index, see
www.bls.gov/ect/sp/echealth.pdf.
Standard errors for the employer
cost changes are not available
for estimates prior to 1996 and
for the period from March 2003
to September 2006. Thus, the
statistical reliability of some
estimates within the series cannot
be judged. See www.bls.gov/opub/
cwc/cm20030825ar01p1.htm.)
Access rates to
health care benefits
and participation in
health plans
Seventy-one percent of private
industry workers had access to
employer-provided medical care
benefits in 2008, while 87 percent
of State and local government
workers had access. Access to
other types of health care benefits—
U.S. BUREAU OF LABOR STATISTICS
dental care, vision care, and
outpatient prescription drug
coverage—also is shown in Table 1.
The take-up rate—the percentage
of workers with access who
participate in the plans—for
private industry was 75 percent
and for government workers was
83 percent. As shown in Table 2,
health savings accounts are
available to 8 percent of private
industry workers and 20 percent of
State and local government workers.
Health care reimbursement
accounts are more prevalent in
both sectors—33 percent for
private industry and 59 percent
for government. Wellness programs,
fitness centers, and employee
assistance programs are also
www.bls.gov/ ebs
more prevalent in government than
in private industry. (For further
information, see www.bls.gov/ebs/
#bulletins.)
Costs per hour
worked
Another way of analyzing
health care costs to employers
is to examine the cost per hour
worked. In March 2008, State and
local government employers paid
$4.15 towards health care benefits.
Private industry employers paid
$1.92. (For further information,
see www.bls.gov/ect.)
Employers pay a higher
percentage of the total premium
for employees with single
coverage than for employees
with family coverage. In private
industry, employers paid an
average of 81 percent of the total
premium for single coverage and
71 percent for family coverage.
continued on back page
►
TABLE 2
Access to selected health benefits, all workers, by private
industry and State and local government, March 2008
(in percent)
Private industry
State and local
government
Health savings accounts
8
20
Healthcare reimbursement
accounts
33
59
Wellness programs
25
52
Fitness centers
13
23
Employee assistance programs
42
73
Selected benefit
OCTOBER 2008 • PROGRAM PERSPECTIVES
3